Attention Parents of 5Th Grade Students

2015 / 2016

6th Grade

Immunization Requirements

ATTENTION PARENTS OF 5TH GRADE STUDENTS

Dear Parent/Guardian:

The purpose of this letter is to inform you about a change in the immunization requirements for school related to the Pertussis (whooping cough) vaccine that took effect September 1, 2007, the varicella vaccine (Effective July 1, 2014) and Polio vaccine (Effective July 1, 2015) The school must be provided with acceptable proof of immunity. Failure to provide this proof may lead to exclusion from school. The key points regarding the requirements of the law and its implementation for September 2015 are as follows:

1.  Students who are entering 6th grade or a comparable age-level education school program and who are 11 years of age or older must receive an immunization containing tetanus toxoids, diphtheria, and acellular pertussis (Tdap). 10-year-old students who are entering 6th grade will not be required to receive a Tdap vaccine until they are 11 years of age and will not be excluded from school, but they must be flagged, tracked and immunized when they reach the age of 11.

2.  Two doses of Varicella vaccine are required to enter 6th grade.

3.  Four doses or three doses if the 3rd dose was received ate age 4 or older of polio vaccine are required to enter 6th grade.

Your private health care provider should be able to review your child’s immunization record and advise you on making sure your child is adequately immunized for entry into the 6th grade. If you do not have health insurance, you may contact the Orange County Department of Health at (845)291-4281 for free immunizations. Please have your health care provider complete the enclosed form and return it to the School Nurse in your child’s building. This means that if your records are complete before the end of the school year they should be sent to the Elementary School your child is attending. If they are completed over the summer they should be sent to the Middle School prior to the first day of classes. If you have any questions you may contact your child’s school nurse. Thank you for your anticipated cooperation.

Constance F. Griffin, RN, AE-C, NCSN

Valley Central Middle School Nurse

845-457-2400 Ext. 16700

Dear Health Care Provider:

As you are no doubt aware there have been changes in the immunization requirements for school entry related to diphtheria, tetanus and pertussis vaccine, varicella vaccine and the polio vaccine. Please furnish the immunization information needed on the lower half of this form for the 2015 / 2016 school year. The key points regarding the 2015 / 2016 requirements of this law are listed below for your reference. Thank you.

1.  Students who are entering 6th -12th grade or a comparable age-level education school program on or after September 1, 2012 and who are 11 years of age or older must receive an immunization containing tetanus toxoids, diphtheria, and acellular pertussis (Tdap).

2.  Two doses of Varicella vaccine are required for students in 6-7th grade.

3.  Four doses of Polio vaccine or three doses if the 3rd dose was given at four years of age or older are required for students in 6-7th grade.

______

Please fill in the blanks below:

This child ______DOB: ______

(Student name)

Received a Tdap vaccine on ______

(Date)

Received a second dose of Varicella vaccine on ______

(Date)

Received a fourth dose of Polio vaccine on _______

(Date)

Health Care Provider’s signature: ______

(Please Sign and Stamp)